KAVANTISSA MONARAWILA KEPPETIPOLA MD
NPI 1013475201
Neurological Surgery in Gainesville, GA

Active since March 06, 2019PECOS EnrolledAccepts Medicare Assignment
1315 JESSE JEWELL PKWY NE STE 300, GAINESVILLE, GA 30501(770) 219-9678 Get Directions Write a Review

NPPES record last updated: August 26, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 26, 2026, Mar 6, 2019 (2 updates tracked since 2019).

About Kavantissa Monarawila Keppetipola Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KAVANTISSA MONARAWILA KEPPETIPOLA MD (NPI 1013475201) is an individual neurological surgery provider in Gainesville, Georgia, licensed in Georgia (113510) and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS, maintains a secondary practice location in Chicago, and is a graduate of Rush Medical College Of Rush University (2019).

NPPES Registry Identity

NPI1013475201
Entity TypeIndividualMale
Primary Taxonomy207T00000X
Provider Legal NameKAVANTISSA MONARAWILA KEPPETIPOLACredential: MD
Location Address1315 JESSE JEWELL PKWY NE STE 300Gainesville, GA 30501-3875
Mailing AddressPo Box 742616Atlanta, GA 30374-2616 · (770) 219-4020
Sole ProprietorNo
Medical School CMSRush Medical College Of Rush UniversityGraduated 2019
Enumeration DateMarch 6, 2019
Last NPPES UpdateAugust 26, 20262 updates tracked since enumeration
NPPES CertifiedAugust 26, 2026
✔ NPI 1013475201 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNeurological SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207T00000X
License✔ Licensed in GA · 113510
Definition
A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution.
1315 JESSE JEWELL PKWY NE STE 300, Gainesville, GA 30501

Secondary Practice Location 1

Location 1600 S Paulina StChicago, IL 60612-3806 · Phone (312) 942-7100

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kavantissa Monarawila Keppetipola Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3577890540
PECOS Enrollment IDI20260707000154
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kavantissa Keppetipola reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Family Medicine
743 SPRING ST NE
Gainesville, GA 30501
  • Reassigned Medicare billing, Georgia enrollment
  • 1,172 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30501 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$124.10 typical visit price
range $53.31 – $164.04
Typical copayment $31.02 (range $13.32 – $41.01)
Most-billed visit code 99204
Established Patient
$66.89 typical visit price
range $16.68 – $133.24
Typical copayment $16.72 (range $4.17 – $33.31)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
1315 JESSE JEWELL PKWY NE STE 300
GAINESVILLE, GA 30501
Orthopaedic Surgery
1315 JESSE JEWELL PKWY NE STE 300
GAINESVILLE, GA 30501
Clinical Neuropsychologist
1315 JESSE JEWELL PKWY NE STE 300
GAINESVILLE, GA 30501
Physician Assistant (Medical)
1315 JESSE JEWELL PKWY NE STE 300
GAINESVILLE, GA 30501
Family Medicine
1315 JESSE JEWELL PKWY NE STE 300
GAINESVILLE, GA 30501
Physician Assistant (Surgical)
1315 JESSE JEWELL PKWY NE STE 300
GAINESVILLE, GA 30501
Psychiatry & Neurology (Neurology)
1315 JESSE JEWELL PKWY NE STE 300
GAINESVILLE, GA 30501
Physician Assistant (Surgical)
1315 JESSE JEWELL PKWY NE STE 300
GAINESVILLE, GA 30501

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kavantissa Keppetipola's NPI number?

The NPI number for Kavantissa Keppetipola is 1013475201. It was assigned to this individual provider in the NPPES registry on March 6, 2019.

Where is Kavantissa Keppetipola located?

Kavantissa Keppetipola practices at 1315 Jesse Jewell Pkwy NE Ste 300, Gainesville, GA 30501. The listed phone number is (770) 219-9678.

What is Kavantissa Keppetipola's specialty?

The primary specialty registered for this NPI is Neurological Surgery with taxonomy code 207T00000X.

Is Kavantissa Keppetipola enrolled in Medicare?

Yes. Kavantissa Keppetipola is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Kavantissa Keppetipola's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kavantissa Keppetipola reassigns Medicare benefits to Northeast Georgia Physicians Group Inc (Gainesville, GA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kavantissa Keppetipola's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kavantissa Keppetipola was last updated on August 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.